Kunelskaya N L, Guseva A L, Manaenkova E A, Chugunova M A, Zaoeva Z O
Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia.
Pirogov Russian National Research Medical University, Moscow, Russia.
Vestn Otorinolaringol. 2023;88(2):4-9. doi: 10.17116/otorino2022880214.
Registration of ocular and cervical vestibular evoked myogenic potentials (oVEMPs and cVEMPs) reflects the function of otolith receptors: sacculus and utriculus. Benign paroxysmal positional vertigo (BPPV) is a disease of the inner ear as a result of the utriculus disfunction and migration of otoliths into semicircular channels.
To study the function of otolith receptors (sacculus and utriculus) with using VEMPs registration in patients with first-time and recurrent posterior semicircular canal BPPV before and after repositional maneuvers.
Registration and comparison of the results of oVEMPs and cVEMPs were performed in 50 patients with first-time posterior semicircular canal idiopathic BPPV and 26 patients with recurrent posterior semicircular canal BPPV before and after repositional treatment.
Clinically significant asymmetry of the amplitude of oVEMPs before treatment was recorded in 14 (38%) of patients with first-time BPPV and in 15 (57.7%) of patients with recurrent BPPV; cVEMPs - in 6 (12%) of patients with first-time BPPV and in 6 (23.1%) of patients with recurrent BPPV. Successful repositional treatment did not affect the amplitude of cVEMPs in any of the groups of patients, but led to a significant increase in the amplitude of oVEMPs on the affected side in patients with first-time BPPV. In patients with recurrent BPPV, despite the absence of symptoms of otolithiasis, the asymmetry of the amplitude of oVEMPs persisted during remission (<0.05), which can be considered as a prognostically unfavorable factor of disease recurrence.
眼震电图和颈性前庭诱发肌源性电位(oVEMPs和cVEMPs)的记录反映了耳石感受器(球囊和椭圆囊)的功能。良性阵发性位置性眩晕(BPPV)是一种内耳疾病,是由于椭圆囊功能障碍和耳石移位至半规管所致。
通过记录VEMPs来研究初次发作和复发性后半规管BPPV患者在复位操作前后耳石感受器(球囊和椭圆囊)的功能。
对50例初次发作的后半规管特发性BPPV患者和26例复发性后半规管BPPV患者在复位治疗前后进行oVEMPs和cVEMPs结果的记录与比较。
初次发作BPPV患者中有14例(38%)、复发性BPPV患者中有15例(57.7%)在治疗前记录到具有临床意义的oVEMPs振幅不对称;初次发作BPPV患者中有6例(12%)、复发性BPPV患者中有6例(23.1%)记录到cVEMPs振幅不对称。成功的复位治疗在任何一组患者中均未影响cVEMPs的振幅,但导致初次发作BPPV患者患侧oVEMPs振幅显著增加。在复发性BPPV患者中,尽管没有耳石症症状,但在缓解期oVEMPs振幅的不对称仍然存在(<0.05),这可被视为疾病复发的预后不良因素。